Suchergebnisse

Fentanyl analogs are synthetic opioids used for pain treatment and palliative care, which are also sought after by drug users for their psychoactive properties. Clandestinely produced fentanyl has caused an overdose crises of unprecedented scale in the United States. In Sweden, the retail purchase, possession, and use of some analogs are legal, providing opiate users with a legal alternative, until the process of scheduling is finished. The continuous process of scheduling and introduction of slightly modified variants implies that there is much uncertainty regarding the potency and quality of newly introduced analogs. We examine user perceptions of fentanyl analogs in a thematic analysis of the public internet forum, Flashback, from 2012 to 2019. In 24 threads on fentanyl analogs, posters shared and discussed information on the emergence of new analogs, their desirability and prices, adverse health effects, and eventual scheduling.

AbstractDrug use has previously been identified as a risk factor for child-to-parent abuse. We examine how common it is for parents to be exposed to physical violence and property damage by adult children with drug problems, and whether such victimization varies based on factors related to the parents and the adult children, respectively. A self-report questionnaire on victimization was completed by 687 parents of adult children with drug problems. The data were collected via a postal questionnaire to members of the Parents Against Drugs association and a web-based questionnaire to persons recruited via social media, treatment centers and other associations for families of drug users. The proportion of parents who reported having been exposed to physical violence was 19% ever, 6% during the past year. The proportion who had been exposed to property damage was 40% ever, 10% during the past year. Exposure during the past year was higher among parents whose children were currently experiencing drug problems. Mental health problems in the children were associated with higher levels of parental victimization, particularly in the form of physical violence. Parental victimization was also associated with the children being younger and still living at home. Exposure to property damage was higher among parents of male children. Adult children's drug problems are of significance for parental victimization; they do not however appear to constitute a major risk factor but rather one risk factor among several others. Exposure to physical violence is clearly related to the presence of mental health problems in the children.

BackgroundNational guidelines are being produced at an increasing rate, and politicians and managers are expected to promote these guidelines and their implementation in clinical work. However, research seldom deals with how decision-makers can perceive these guidelines or their challenges in a cultural context. Therefore, the aim of this study was twofold: to investigate how well Promoting Action on Research Implementation in Health Services (PARIHS) reflected the empirical reality of mental healthcare and to gain an extended understanding of the perceptions of decision-makers operating within this context, in regard to the implementation of evidence-based guidelines.MethodsThe study took place in the southeast of Sweden and employed a qualitative design. The data were collected through 23 interviews with politicians and managers working either in the county council or in the municipalities. The transcribed text was analysed iteratively and in two distinct phases, first deductively and second inductively by means of qualitative content analysis.ResultsOur deductive analysis showed that the text strongly reflected two out of three categorisation matrices, i.e. evidence and context representing the PARIHS framework. However, the key element of facilitation was poorly mirrored in the text. Results from the inductive analysis can be seen in light of the main category sitting on the fence; thus, the informants' perceptions reflected ambivalence and contradiction. This was illustrated by conflicting views and differences in culture and ideology, a feeling of security in tradition, a certain amount of resistance to change and a lack of role clarity and clear directions. Together, our two analyses provide a rich description of an organisational culture that is highly unlikely to facilitate the implementation of the national guidelines, together with a distrust of the source behind such guidelines, which stands in stark contrast to the high confidence in the knowledge of experienced people in authority within the ...

National guidelines are being produced at an increasing rate, and politicians and managers are expected to promote these guidelines and their implementation in clinical work. However, research seldom deals with how decision-makers can perceive these guidelines or their challenges in a cultural context. Therefore, the aim of this study was twofold: to investigate how well Promoting Action on Research Implementation in Health Services (PARIHS) reflected the empirical reality of mental healthcare and to gain an extended understanding of the perceptions of decision-makers operating within this context, in regard to the implementation of evidence-based guidelines.

Aims: Studies investigating mental health professionals' attitudes towards people with mental illness are scarce and there is a lack of comparative studies including both patients' and mental health professionals' attitudes. The aim of the present study was to investigate mental health staff's attitudes towards people with mental illness and compare these with the attitudes of patients in contact with mental health services. A further aim was to relate staff attitudes to demographic and work characteristics. Methods: A cross-sectional study was performed including 140 staff and 141 patients. The study included a random sample of outpatients in contact with mental health services in the southern part of Sweden and staff working in these services. Attitudes were investigated using a questionnaire covering beliefs of devaluation and discrimination of people with a mental illness. Results: Negative attitudes were prevalent among staff. Most negative attitudes concerned whether an employer would accept an application for work, willingness to date a person who had been hospitalized, and hiring a patient to take care of children. Staff treating patients with a psychosis or working in inpatient settings had the most negative attitudes. Patient attitudes were overall similar to staff attitudes and there were significant differences in only three out of 12 dimensions. Patients' most negative attitudes were in the same area as the staff's. Conclusions: This study points to the suggestion that mental health care staff may hold negative attitudes and beliefs about people with mental illness with tentative implications for treatment of the patient and development and implementation of evidence-based services. Since patients and staff in most respects share these beliefs, it is essential to develop interventions that have an impact on both patients and staff, enabling a more recovery-oriented staff–patient relationship.

In this work we present a significant advancement in cubic silicon carbide (3C-SiC) growth in terms of crystal quality and domain size, and indicate its potential use in photovoltaics. To date, the use of 3C-SiC for photovoltaics has not been considered due to the band gap of 2.3 eV being too large for conventional solar cells. Doping of 3C-SiC with boron introduces an energy level of 0.7 eV above the valence band. Such energy level may form an intermediate band (IB) in the band gap. This IB concept has been presented in the literature to act as an energy ladder that allows absorption of sub-bandgap photons to generate extra electron-hole pairs and increase the efficiency of a solar cell. The main challenge with this concept is to find a materials system that could realize such efficient photovoltaic behavior. The 3C-SiC bandgap and boron energy level fits nicely into the concept, but has not been explored for an IB behavior. For a long time crystalline 3C-SiC has been challenging to grow due to its metastable nature. The material mainly consists of a large number of small domains if the 3C polytype is maintained. In our work a crystal growth process was realized by a new approach that is a combination of initial nucleation and step-flow growth. In the process, the domains that form initially extend laterally to make larger 3C-SiC domains, thus leading to a pronounced improvement in crystalline quality of 3C-SiC. In order to explore the feasibility of IB in 3C-SiC using boron, we have explored two routes of introducing boron impurities; ion implantation on un-doped samples and epitaxial growth on un-doped samples using pre-doped source material. The results show that 3C-SiC doped with boron is an optically active material, and thus is interesting to be further studied for IB behavior. For the ion implanted samples the crystal quality was maintained even after high implantation doses and subsequent annealing. The same was true for the samples grown with pre-doped source material, even with a high concentration of boron impurities. We present optical emission and absorption properties of as-grown and boron implanted 3C-SiC. The low-temperature photoluminescence spectra indicate the formation of optically active deep boron centers, which may be utilized for achieving an IB behavior at sufficiently high dopant concentrations. We also discuss the potential of boron doped 3C-SiC base material in a broader range of applications, such as in photovoltaics, biomarkers and hydrogen generation by splitting water. (C) 2015 Elsevier B.V. All rights reserved. ; Funding Agencies|Angpanneforeningen Research Foundation (AForsk); NFR SunSic project; Swedish Energy Agency; Swedish Governmental Agency for Innovation Systems (Vinnova); STAEDTLER Foundation

In this much-needed text, leading international experts explore crucial aspects of people's experience of long-term recovery from substance use. Centred around the voices of people who use substances, the book examines the complex and continuing needs of people who have sought to change their use of substances, investigating the ways in which personal characteristics and social and systemic factors intersect to influence the lives of people in long-term recovery. With perspectives from Sweden, Norway, Germany, Belgium, Iceland and the United Kingdom, it also considers the role and needs of family members, and puts forward clear recommendations for improving future research, policy and practice